This is pdf file for basic knowledge for nursing care for Gavage feeding in neonatal care in intensive care unit ( ICU ) .

1. GAVAGE FEEDING
OR
NASOGASTRIC FEEDING

2. Prepared: Riya yadav
Class :B. Sc. Nursing , Third years
Sub : Child Health Nursing

3. Nasogastric Tube
feeding

4. Gavage feeding
Gavage feeding is an artificial method of
giving milk , fluids and nutrients to children .
The process of feeding with the tube inserted
through the nose , pharynx and oesophagus into
the stomach to provide nutrition to the child

7. Definition
A tube placed through
child`s nose (called a
Nasogastric or NG tube )
carries breast milk /formula
,and nutrients to the
stomach.

8. Purpose and indications
To feed the children who are unable to
take feed orally .
Feed the children who are undergoing oral
surgery like cleft lip or cleft palate , fracture
or jaw and in condition of difficulty in
swallowing .

10. When patients is unconscious or
semiconscious
When the condition is not supportive to
take large amount of food orally e. g.
severe burns ,malnutrition ,prematurity
,acute and chronic infections .
Conditions when the patient is unable to
retain the food e. g anorexia nervosa and
vomiting .

11. Types of Tube Feeding
Intermittent : The feeding tube
may be inserted and remove
at each feeding .
Indwelling : The feeding tube
is inserted and left taped
securely .

12. Advantages of Nasogastric feeding
All types of nutrients including
distasteful foods and medications can
be given in adequate amount.
Without any danger, feeding can be
continued for weeks.
According to need, stomach can be
aspirated at any time

13. Cont…….
Large amount of fluids can be
given with safety.

14. Principals involved in Gastric Gavage
Tube feeding is a process of giving liquid
nutrients or medications through a tube into
the stomach when the oral intake is
inadequate or impossible
 A thorough knowledge of the anatomy and
physiology of the digestive tract and
respiratory tract .Ensure safe induction of
the tube (avoid misplacement of the tube ).

16. POLICY
6 ft feeding tube is used for infants <1000
grams .
6 ft or # ft feeding tube are used for infants
>1000 grams.
Never force the feeding under pressure.

17. CONT…………
If possible, the infant should be held in semi – up-
right
Possible during the feeding ; if not possible
,position infant on right side or prone as this will
facilitate gastric emptying .
If respiratory rate > 70, check with physician
about withholding feeding .

18.  Feeding tube of baby and child size
 Stethoscope
 5 -10 cc syringe
 Ryle`s tube in a bowel
 Adhesive tape
 Sterile formula Feed .

20. Cotton tipped “ application to clean the
nostrils
Examine the mouth of patient with tongue blade and light
source

21. Procedure
Explain the procedure to child and
relative
Give recumbent position with his neck
hyper flexed with a rolled towel place
under the , sometime restrain may
required .
Measure the tube by measuring from the
bridge of the nose to umbilicus in infants
and mark it .

22.  In older children , measure from the nose to
earlobe and then to the tip of the xiphoid
process of sternum

23. Lubricate catheter with water
Insert the catheter with water
Insert the catheter through nares and or
mouth in case of nasogastric feeding
.slip the catheter into nostril and direct
towards the occiput in a horizontal plane .
 In case of orogastric feeding pass the
catheter through the mouth towards the
back of throat.

24. Clamp the catheter and withdraw it
Burp child and place on the abdomen.
Observe for vomiting ,apnea ,abdominal
distension
Observer for abdominal distension
,regurgitation ,vomiting , gastric residue
,25 -50% or more than of that of the
previous feed indicates poor tolerance to
enteral feeding.

25. Record the procedure including
type and amount of feeding ,time
and observe child responses
during feeding.

26. Gastrostomy feeding
 A gastrostomy is a feeding tube that is
surgically placed through the abdominal wall ,
to feed formula ,liquids and medication directly
into the stomach . The tube usually has a
balloon or disk placed under the skin that
holds the tube in place . It also has a retention
device ( often called a button )
On the outside of the skin to seal the tube
between feeds.

27. Definition
 The process of feeding a child through a tube directly
inserted into stomach through the abdominal wall is
known as gastrostomy feeding .
 Gastrostomy feeding may be an option when a child has
swallowing problems (dysphagia) making it difficult for
the them to safely swallow food and drink , or

28. Indication of Gastrostomy tube feeding
 Congenital abnormalities of the mouth ,esophagus , stomach ,or
intestines
 Sucking and swallowing disorders , which are often related to
prematurity , brain injury , development delay , or certain
neuromuscular conditions , like severe cerebral palsy
 Failure to thrive , which is a general diagnosis that refers to a
child`s inability to gain weight and grow appropriately
 Extreme difficulty taking medicines
 When maintaining healthy rates of growth and nutritional wellbeing
cannot be achieved by oral feeding alone.

31. Purpose
To feed a child who is unable to feed orally
 To provide nourishment in child with congenital
anomaly ,such as trachea esophageal fistula
 To decompress the stomach

32. Articles
Warm feeding formula
Sterile water
Mackintosh and towel
20 -50 cc syringe

33. Procedure of feeding
 Collect and check articles for functioning
 Place the child in proper position : hold child elevated
 Place mackintosh and towel on child`s abdomen
 Attach tubing to syringe and elevate syringe to 10-20 cm .
 Aspirate gently
 Pour feed and allow flow them with the help of gravity .
Feed for 20- 30 minutes.
 Irrigate with clear water .

34. After feeds , the tube may be :
Left unclamped to provide constant
decompression
Elevate and covered with gauge to
prevent gastric reflux and abdominal
distension
Clamped if patient is to be prepared
for home care .

35. CONT……….
 Don’t apply pressure
 Record types , amounts of feed , and child`s
activity
 Keep child in fowlers position or turned right
 Tube should be secured in place to minimize
traction .
 Keep the tube area clean and dry.